Dual Pathologies: Pial Arteriovenous Fistula in Combination with an Arteriovenous Malformation.
Adult
Angiography, Digital Subtraction
Arteriovenous Fistula
/ complications
Cerebral Angiography
Cerebral Veins
/ diagnostic imaging
Female
Humans
Intracranial Arteriovenous Malformations
/ complications
Magnetic Resonance Imaging
Middle Cerebral Artery
/ pathology
Neurosurgical Procedures
Patient Care Planning
Tomography, X-Ray Computed
Treatment Outcome
Journal
Journal of neurological surgery. Part A, Central European neurosurgery
ISSN: 2193-6323
Titre abrégé: J Neurol Surg A Cent Eur Neurosurg
Pays: Germany
ID NLM: 101580767
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
pubmed:
15
1
2020
medline:
12
9
2020
entrez:
15
1
2020
Statut:
ppublish
Résumé
A pial arteriovenous fistula (PAVF) is a rare neurovascular pathology consisting of a direct connection between one or more arterial feeders and a single venous channel. A PAVF was previously considered a subtype of an arteriovenous malformation (AVM). In the current literature these are distinguished as two independent entities with different clinical, physiopathologic, and structural characteristics. We report a case of a surgically treated 37-year-old woman with an extremely rare combination of an unruptured PAVF and AVM. The AVM was mainly supplied by feeders of the middle cerebral artery and drained into the sigmoid sinus via an abnormally dilated and tortuous vein. Following its resection, intraoperative digital subtraction angiography (DSA) in the hybrid operating room revealed the presence of a PAVF that had not been noted during the preoperative planning. Hence the PAVF was completely disconnected as confirmed by DSA again. This is the second reported case of an AVM-associated PAVF. Without the intraoperative DSA in the hybrid operating room, this unusual complex cerebrovascular entity would likely have been missed.
Sections du résumé
BACKGROUND
BACKGROUND
A pial arteriovenous fistula (PAVF) is a rare neurovascular pathology consisting of a direct connection between one or more arterial feeders and a single venous channel. A PAVF was previously considered a subtype of an arteriovenous malformation (AVM). In the current literature these are distinguished as two independent entities with different clinical, physiopathologic, and structural characteristics. We report a case of a surgically treated 37-year-old woman with an extremely rare combination of an unruptured PAVF and AVM.
PATIENT
METHODS
The AVM was mainly supplied by feeders of the middle cerebral artery and drained into the sigmoid sinus via an abnormally dilated and tortuous vein. Following its resection, intraoperative digital subtraction angiography (DSA) in the hybrid operating room revealed the presence of a PAVF that had not been noted during the preoperative planning. Hence the PAVF was completely disconnected as confirmed by DSA again.
CONCLUSION
CONCLUSIONS
This is the second reported case of an AVM-associated PAVF. Without the intraoperative DSA in the hybrid operating room, this unusual complex cerebrovascular entity would likely have been missed.
Identifiants
pubmed: 31935781
doi: 10.1055/s-0039-1698398
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
185-187Informations de copyright
Georg Thieme Verlag KG Stuttgart · New York.
Déclaration de conflit d'intérêts
Holger Joswig reports personal fees from UCB Pharma Canada and grants from Medtronic, outside the submitted work.